Is ICD-10-CM code J86 billable?

No, J86 (Pyothorax) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code J86 belong to?

J86 belongs to Chapter 10 of the ICD-10-CM tabular list: J00–J99 (Diseases of the Respiratory System).

J86Not billable, use a more specific code below

Pyothorax

In Suppurative and necrotic conditions of the lower respiratory tract (J85-J86), chapter 10: Diseases of the Respiratory System

2 billable codes under J86: all are an MCC; all map to HCC 283 (Empyema, Lung Abscess).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.

Instructional notes

Excludes1: not coded here, use a different code

abscess of lung (J85.-)
pyothorax due to tuberculosis (A15.6)

Use additional code: add a second code for this, listed after this one

code (B95-B97) to identify infectious agent.

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Covers COPD and asthma exacerbations, sequencing of acute respiratory failure, confirmed versus suspected identified influenza, ventilator associated pneumonia, and vaping-related disorders.

Chronic Obstructive Pulmonary Disease [COPD] and Asthma (page 56)
Acute Respiratory Failure (page 56)
Influenza due to certain identified influenza viruses (page 57)
Ventilator associated Pneumonia (page 57)
Vaping-related disorders (page 58)

Read Section I.C.10 (page 56)

All codes under J86

J86 can't be used on a claim. Pick a billable code below; grey headings group them.

J86 MS-DRGs

As the principal diagnosis, all 2 billable codes under J86 group to MS-DRG 177, 178, 179, 791, or 793 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

Other codes that refer to J86

Notes on these codes point to J86.

J93 Excludes1: pyopneumothorax (J86.-)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Abscess

An abscess is a pocket of pus. You can get an abscess almost anywhere in your body. When an area of your body becomes infected, your body's immune system tries to fight the infection. White blood cells go to the infected area, collect within the damaged tissue, and cause inflammation. During this process, pus forms. Pus is a mixture of living and dead white blood cells, germs, and dead tissue.

Chest Injuries and Disorders

The chest is the part of your body between your neck and your abdomen (belly). The medical term for your chest is thorax. Your chest holds many important structures for breathing, digestion, blood circulation, and other important body functions. These structures include your:

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.